Predicting and Overcoming Pain

New research supported by the National Institutes of Health suggests that the brain’s underlying structure may predict whether a person will suffer chronic pain, and that brain structure may actually be more important to our pain experience than the physical site of injury.

Dr. Vania Apkarian and his colleagues at Northwestern University’s Feinberg School of Medicine performed MRI scans on patients who had suffered lower back pain for approximately three months. Subjects who had persistent pain that continued for up to a year showed decreased grey matter volume in their brains.

The researchers also found that brain activity levels could predict whether a volunteer recovered from their pain or experienced ongoing pain.In addition, the scientists used an MRI scanning technique called diffusion tensor imaging (DTI) — which measures white matter connections between nerve cell wires in different parts of the brain.

They found that the white matter connections between various brain regions differed significantly in people who recovered from pain compared with those who experienced chronic pain.

Even though brain structure can predict a person’s risk for developing chronic pain, therapeutic interventions can help our minds to overcome such structural predispositions to pain.Dr. David Seminowicz and his co-workers at the University of Maryland measured grey matter volume in the brains of chronic pain patients before and after they underwent 11 weeks of cognitive behavioral therapy. The treatment led to significant improvements in pain symptoms, and the patients’ grey matter volume increased significantly in several brain regions, including:

•Prefrontal cortex

•Parietal region

•Anterior cingulate

•Sensorimotor area

•Hippocampus

The increased grey matter in the prefrontal and parietal regions may provide these patients with better cognitive control over pain.

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